Olufunto A. Olusanya

Purpose: Invasive cervical cancer (ICC) cases remain a major public health concern for women in Nigeria. The purpose of this scoping review is to assess the reporting of common human papillomavirus (HPV) genotypes found in ICC cases among Nigerian women. Methods: We searched five databases, including Embase, Ovid Medline, Scopus, Cochrane Database of Systematic Reviews, and Google Scholar, to identify studies reporting HPV genotypes found in ICC cases in Nigeria. Study selection and data extraction were conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Two researchers extracted data from each eligible article. Results: A total of 668 records were identified, of which 422 studies were screened and six articles met the eligibility criteria. The included studies reported on HPV genotypes detected in ICC among Nigerian women. Across the studies, high-risk HPV (hrHPV) types 16, 18, 35, and 45 were identified in approximately 50% of ICC cases, whereas other detected genotypes included hrHPV types 31, 33, 51, and 52. Notably, in addition to globally predominant hrHPV types 16 and 18, hrHPV types 35 and 45 were also frequently detected, indicating their significant contribution to the ICC burden among Nigerian women. Conclusion: After an extensive search, this study provides a comprehensive assessment of the overall prevalence and distribution of hrHPV genotypes in Nigerian women with ICC. The most common hrHPV genotypes detected in ICC in Nigeria are 16, 18, 35, 45, 31, 33, 51, and 52. hrHPV types 16 and 18 account for the majority of cases, but in Nigeria and among women of African descent worldwide, hrHPV types 45 and 35 are also significantly present in ICC cases.

Background: Cervical cancer is a leading cause of death among women in Africa, yet Human papillomavirus (HPV) vaccination and self-collection screening remain underutilized. HPV vaccination significantly reduces cervical cancer risk; additionally, HPV self-collection can improve screening access to prevent progression to invasive cervical cancer. Few studies use theory-driven approaches to examine contextual factors influencing cervical cancer prevention. Guided by the PEN-3 Cultural Model, this qualitative study examined social and cultural influences, facilitators, and preferences related to HPV vaccination and HPV self-collection among Nigerian girls and women. Methods: Semi-structured, in-depth interviews with girls (9–26 years) and women (30–65 years) in Lagos, Nigeria, explored perceptions and preferences related to cervical cancer prevention. Using the PEN-3 cultural model, thematic analysis examined how Cultural Identity, Relationships and Expectations, and Cultural Empowerment domains influenced participants' preferences and behaviors. Multilevel factors such as knowledge gaps, misconceptions, high costs, and limited access were categorized, and positive and negative influences on HPV prevention behaviors were identified. Results: A total of 56 purposively selected participants (girls aged 9–26 years and women aged 30–65 years) were included in the study. For HPV vaccination, girls reported that recommendations from the health ministry ( n = 24, 86%), health providers ( n = 24, 86%), and family and friends ( n = 18, 64%) strongly influenced their decisions. For HPV self-collection, adult women prioritized messages from health providers ( n = 27, 96%) and health ministry officials ( n = 25, 89%). Findings demonstrated that multilevel (i.e., individual, relational, sociocultural, and structural) factors influence HPV vaccination and HPV self-collection. Across both groups, limited knowledge, concerns about cost and access, and misconceptions about cervical cancer, some cultural beliefs, including stigma, were identified as barriers to prevention behaviors. For younger participants, family dynamics significantly influenced decision-making. Among older women, concerns related to privacy, trust in healthcare providers, spousal support, and preferences for female providers were described as key drivers for HPV self-collection. Participants expressed a strong preference for affordable, accessible vaccines and self-collection kits available at health facilities and pharmacies. Conclusion: Culturally grounded cervical cancer prevention strategies that align with women's preferences and leverage existing community resources are essential for empowering informed decision-making and increasing HPV vaccination and self-collection.

Introduction: The timely administration of the birth-dose hepatitis B (HepB-BD) vaccine is recommended by global and national guidelines to effectively prevent perinatal transmission. In high-disease-burden countries, such as Nigeria, the adoption of the HepB-BD vaccine remains limited. Emerging global policy discussions highlight the need to examine healthcare workers’ (HCWs’) perceptions of pediatric vaccination guidelines, the safety and effectiveness of the HepB-BD vaccine, and how family, social support, and community factors influence vaccine delivery. Methods: A convergent mixed-methods study of HCWs was conducted in Nigeria between July and August 2024. Using the PEN-3 Cultural Model as our framework, we concurrently administered quantitative surveys and conducted in-depth qualitative interviews and focus group discussions to assess knowledge, beliefs, and peer influences related to HepB-BD vaccinations. We also explored HCWs’ perceptions, enabling factors, and social influences that impact vaccine delivery. Data were analyzed using descriptive statistics and thematic analysis. Results: Most participants were women (87.8%), nurses (24.4%), and community extension workers (14.6%), with an average age of 32.5 years. Over half perceived HepB-BD vaccines as extremely safe (61%) and effective (63.4%). Participants strongly agreed that birth vaccination is recommended (80.5%), ethically appropriate (68.3%), and that its benefits outweigh side effects (63.4%). Most respondents reported professional autonomy in birth-dose decisions: 51.2% strongly disagreed that family opinions influenced their decisions, and 48.8% strongly disagreed that family/friends were concerned about their administering the vaccine. Qualitative themes included perceptions of barriers (poor knowledge, limited vaccine stock, misinformation), enablers (transportation and cold chain reliability), and nurturing factors (the role of training and collaboration with traditional birth attendants). Misconceptions included linking vaccines to sexually transmitted infections and concerns about fragile newborn immunity. Conclusion: HepB-BD vaccine delivery by HCWs is influenced by a complex interplay of multiple factors, including perceptions, structural enablers, and social relationships. As global policies continue to evolve, programs should adopt culturally responsive, context-specific strategies to address these multi-level influences and foster HCW trust, thereby ensuring the timely delivery of the HepB-BD vaccine.

Background: In fall 2021, Tennessee school districts faced heightened debates over COVID-19 mitigation amid rising cases, limited vaccination availability, and widespread misinformation. School board meetings (SBMs) served as pivotal decision-making forums influencing district policies. This study investigated perceptions and misinformation regarding the COVID-19 mask mandate at SBMs held within 6 of Tennessee’s largest school districts. With widespread debate over pandemic measures, including mask use in schools, understanding community sentiments is crucial for guiding public health policies. Objective: This study aimed to investigate the viewpoints of parents or caregivers and teachers regarding COVID-19 safety protocols, particularly the mask mandate, and to identify the misinformation circulating within SBMs. Methods: Participants’ commentaries were extracted from 6 SBM recordings that were publicly uploaded to YouTube from August through September 2021. The data were examined qualitatively to capture themes related to concerns, support, and misinformation. Inductive thematic analysis was conducted using transcripts generated via Microsoft Azure speech-to-text and manually verified. Results: Many parents or caregivers gave personal accounts of how the pandemic had impacted them, their children, and their communities, describing significant comorbidities, adverse psychosocial impacts, mental health disorders, learning difficulties, and worsening socioeconomic and educational disparities. Six thematic domains emerged: (1) perceived effects of the COVID-19 pandemic on children, teachers, and parents or caregivers, including psychosocial distress, learning disruptions, and burnout; (2) perceived effects of mask mandates on children, particularly concerns regarding physical health and psychosocial well-being; (3) perceived government overreach and legal objections to COVID-19 mitigation mandates; (4) tensions between personal liberty, religious beliefs, and collective responsibility in masking decisions; (5) circulation of misinformation and conflicting guidance regarding mask safety and effectiveness; and (6) institutional strain, social tensions, and hostility directed toward school officials alongside educator burnout. Conclusions: Perspectives on COVID-19 mitigation varied widely across meeting participants, highlighting the need for health officials and policymakers to engage in proactive health promotion strategies. Strengthening public health communication, misinformation mitigation, and institutional support for teachers will be essential to ensuring safe and effective learning environments during future public health crises.

BACKGROUND Despite many evidence-based HIV interventions, most research findings are not disseminated. Enhancing research dissemination is essential to achieving Nigeria’s HIV targets. OBJECTIVE This study describes dissemination strategies solicited from the public to share research findings and products from an HIV self-testing intervention among Nigerian adolescents and young adults (AYAs). METHODS A crowdsourcing open call was launched in 2023 for 3 weeks to generate creative ideas for strategies to disseminate research findings and products from an HIV self-testing intervention among young people (aged 14-30 years). Crowdsourcing open calls are structured approaches to solicit community insights. Two people prescreened the submissions for eligibility before judging based on 5 criteria: clear description, desirability to AYAs, innovation, feasibility, and relevance to dissemination. We then conducted an inductive thematic content analysis of eligible submissions to identify key dissemination strategies for HIV research targeting AYAs and used descriptive statistics to characterize participants’ demographic data. RESULTS We received 64 eligible submissions from 24 states in Nigeria. Most (n=34, 53%) participants were male, and (n=18, 28%) were aged ≤18 years (mean age 21, SD 3.08 years). Our analysis identified six major themes reflecting AYA-driven strategies for disseminating HIV research products: (1) the use of digital platforms such as social media, websites, podcasts, and blogs; (2) the use of artistic expressions such as murals, posters, comics, and infographics to communicate key research findings in visually appealing ways tailored to AYAs; (3) community engagement and experiential activities such as door-to-door campaigns and interactive workshops to communicate research products and findings; (4) performance arts such as the use of concerts, open-mic events, dance performances, and fashion events to communicate research findings; (5) storytelling and narratives in the form of stories, drama, and theater as tools for dissemination; and (6) interactive and gamified activities such as mobile apps and board games to engage AYAs with research findings and products. Most submissions (39/64, 61%) recommended local collaboration with schools or community leaders for dissemination. CONCLUSIONS The crowdsourcing open call was feasible and effective in generating ideas for research dissemination among AYAs. Our findings have implications for enhancing research dissemination among AYA populations in several resource-limited settings. Future work should involve evaluating the reach, acceptability, cost, and impact of these dissemination strategies. CLINICALTRIAL

Background: Despite many evidence-based HIV interventions, most research findings are not disseminated. Enhancing research dissemination is essential to achieving Nigeria’s HIV targets. Objective: This study describes dissemination strategies solicited from the public to share research findings and products from an HIV self-testing intervention among Nigerian adolescents and young adults (AYAs). Methods: A crowdsourcing open call was launched in 2023 for 3 weeks to generate creative ideas for strategies to disseminate research findings and products from an HIV self-testing intervention among young people (aged 14-30 years). Crowdsourcing open calls are structured approaches to solicit community insights. Two people prescreened the submissions for eligibility before judging based on 5 criteria: clear description, desirability to AYAs, innovation, feasibility, and relevance to dissemination. We then conducted an inductive thematic content analysis of eligible submissions to identify key dissemination strategies for HIV research targeting AYAs and used descriptive statistics to characterize participants’ demographic data. Results: We received 64 eligible submissions from 24 states in Nigeria. Most (n=34, 53%) participants were male, and (n=18, 28%) were aged ≤18 years (mean age 21, SD 3.08 years). Our analysis identified six major themes reflecting AYA-driven strategies for disseminating HIV research products: (1) the use of digital platforms such as social media, websites, podcasts, and blogs; (2) the use of artistic expressions such as murals, posters, comics, and infographics to communicate key research findings in visually appealing ways tailored to AYAs; (3) community engagement and experiential activities such as door-to-door campaigns and interactive workshops to communicate research products and findings; (4) performance arts such as the use of concerts, open-mic events, dance performances, and fashion events to communicate research findings; (5) storytelling and narratives in the form of stories, drama, and theater as tools for dissemination; and (6) interactive and gamified activities such as mobile apps and board games to engage AYAs with research findings and products. Most submissions (39/64, 61%) recommended local collaboration with schools or community leaders for dissemination. Conclusions: The crowdsourcing open call was feasible and effective in generating ideas for research dissemination among AYAs. Our findings have implications for enhancing research dissemination among AYA populations in several resource-limited settings. Future work should involve evaluating the reach, acceptability, cost, and impact of these dissemination strategies.

While a growing body of scientific literature suggests that evidence-based interventions may improve health outcomes in diverse settings, little is known about the best strategies for large-scale implementation. In Africa, music—an important positive social determinant of health—leverages existing cultural values, which may effectively enhance the reach, uptake, and long-term sustainability of evidence-based interventions in the region. To understand how music interventions work, why they are effective, and with whom they resonate, this systematic review aims to evaluate the quality and empirical application of music as an implementation strategy for adopting evidence-based interventions in Africa using the RE-AIM framework as a guide. A comprehensive librarian-assisted search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five major electronic databases, EBSCOhost, PubMed, Web of Science, Embase, and MEDLINE, were searched for empirical studies focused on using music as an implementation strategy to improve health outcomes in Africa. Two independent investigators extracted components of retrieved papers using the RE-AIM framework as a guide. From 981 citations, eight studies met the inclusion criteria, each reporting a unique music intervention. The interventions were conducted in West Africa (n = 3), South African regions (n = 4), and East Africa (n = 1) and included seven observational studies and one randomized controlled trial (RCT). Using the RE-AIM scoring criteria, we summarize the RE-AIM dimensions reported from selected studies – Adoption (72.5%) being the highest, followed by Reach (62.5%), Implementation (41.7%), and Efficacy/Effectiveness (20.0%). All eight studies (100%) described the intervention location, the expertise of delivery agents, the target population, and the participant characteristics. Moreover, our analysis highlighted the effectiveness of music interventions in enhancing health outcomes, particularly in improving knowledge and awareness (62.5%), facilitating behavioral change (50%), and promoting mental health (25%). Music interventions adapted to the sociocultural context in Africa have the potential to help prevent diseases, improve well-being, and enhance health outcomes. Our review emphasizes the importance of customizing music-based interventions to fit the cultural context, which can enhance the programs' effectiveness, acceptance, and sustainability. Clinical trials are necessary to confirm the efficacy of music interventions in specific medical conditions and from a public health promotion perspective.

Cervical cancer is a leading cause of cancer deaths among women in Nigeria, yet awareness is low. Historically, art has served as a medium for processing emotions and sharing experiences, which can be effective in promoting health and behavior change. This study aimed to examine art submissions and social media engagement from a Nigerian crowdsourcing open call to inform co-designed strategies for cervical cancer prevention among women. This study reported following the SRQR (Standard Reporting for Qualitative Research) guideline. From October to November 2023, we launched an open call for art on social media, inviting adult women to submit artwork that raises awareness about cervical cancer prevention. Participants' submissions were anonymized and reviewed by an independent panel of judges. A total of 6 finalists were selected to participate in a social media contest during Cervical Cancer Elimination Week, and 3 winners were identified based on total social media likes and comments, as well as grading rubric scores. We analyzed participants' art entries through thematic analysis in six steps: (1) familiarization, (2) creating categories, (3) identifying themes, (4) reviewing themes, (5) defining themes, and (6) discussing findings. The emerging themes included using art to express emotions, to convey health-related content, and to use art as a form of self-regulation, which were further analyzed using the Relationships and Expectations domain of the PEN-3 (perceptions, enablers, and nurturers) cultural model. A total of 43 entries from participants aged 18-27 (mean 22.2, SD 2.6) years were analyzed. The entries included visuals (n=14), audiovisual (n=14), text (n=14), and audio (n=1). Most entries (42/43, 97.6%) focused on cervical cancer and human papillomavirus, covering definitions, risk factors, treatment, and prevention. Using the PEN-3 cultural model's Relationships and Expectations domain for analysis, 62.8% (27/43) addressed "perceptions" of art as a means of mental and emotional expression, reflecting feelings such as humor, sadness, hope, faith, unity, and fear related to cervical cancer prevention. A majority (34/43, 79.1%) aimed to promote human papillomavirus screening and vaccination and were categorized as "enablers," viewing art as a tool for health awareness, including educational resources. Additionally, 7% (3/43) included "nurturers," representing self-regulation addressing stresses linked to having relatives with cervical cancer. Six finalist entries were shared on social media to promote cervical cancer awareness, reaching 8685 individual Instagram accounts and generating 2727 likes and 782 comments. This study used art to increase awareness about cervical cancer on social media. Art can serve as a tool for promoting health by incorporating visual, emotional, and contextual messages to influence the target audience's behavior.

BACKGROUND Cervical cancer is a leading cause of cancer deaths among women in Nigeria, yet awareness is low. Historically, art has served as a medium for processing emotions and sharing experiences, which can be effective in promoting health and behavior change. OBJECTIVE Our study examined art submissions and social media engagement from a crowdsourced open call to co-design promotional strategies for preventing cervical cancer among women in Nigeria. METHODS From October to November 2023, we launched an open call for art on social media, inviting adult women to submit artwork that raises awareness about cervical cancer prevention. Participants’ submissions were anonymized and reviewed by an independent panel of judges. Six finalists were selected to participate in a social media contest during Cervical Cancer Elimination Week, and three winners were identified based on their total likes and comments on social media, including grading rubric scores. We analyzed participants’ art entries through thematic analysis in six steps: 1) familiarization, 2) creating categories, 3) identifying themes, 4) reviewing themes, 5) defining themes, and 6) discussing findings. The emerging themes included using art to express emotions, utilizing art to convey health-related content, and employing art as a form of self-regulation, which were further analyzed using the PEN-3 cultural model. RESULTS Forty-three entries from participants aged 18 to 27 (Mean age 22.2 years) were analyzed. The entries included visuals (n=14), audiovisual (n=14), text (n=14), and audio (n=1). Most entries (97.6%; 42/43) focused on cervical cancer and HPV, covering definitions, risk factors, treatment, and prevention. Using the PEN-3 cultural model's Relationship and Expectation domain for analysis, 62.8% (27/43) addressed “perceptions” about art as a means of mental and emotional expression, reflecting feelings like humor, sadness, hope, faith, unity, and fear relating to cervical cancer prevention. A majority (79.1%; 34/43) aimed to promote HPV screening and vaccination, categorized as “Enablers” that viewed art as a tool for health awareness, including educational resources. Additionally, 7.0% (3/43) included “Nurturers” representing self-regulation addressing stresses linked to having relatives with cervical cancer. Six finalist entries were shared on social media, promoting cervical cancer awareness, reaching 8,685 individual Instagram accounts and generating 2,727 likes and 782 comments on Instagram. CONCLUSIONS This study utilized art to increase awareness about cervical cancer on social media. Art can serve as a tool for promoting health by incorporating visual, emotional, and contextual messages to influence the target audience's behavior.

Introduction/Background: The COVID-19 pandemic has disrupted major aspects of daily life since its emergence in late 2019, impacting health and well-being worldwide. Aside from genetic predisposition, numerous external factors play key roles in determining levels of disease susceptibility and overall health status. Aim/Objectives: This review and policy analysis sought to examine literature focused on the impact of neighborhood environments on population health and well-being during the COVID-19 pandemic period. Examined studies explore the impacts of various aspects of the neighborhood environment (i.e., walkability, transportation, access to healthcare/vaccination, etc.) during the COVID-19 era on population health and well-being. Methods: Databases were searched for studies published from March 2020 to August 2022. Selected studies examine the impacts of various aspects of the neighborhood environment (i.e., walkability, transportation, access to healthcare/vaccination, climate, crime rates, persistent poverty, the social spread of misinformation, etc.) during the COVID-19 era on population health and well-being. Results: Findings from our review suggest that those living in less-than-favorable environments were faced with significant challenges, making vulnerable populations more prone to the severity of COVID-19 infection. Conclusion: We argue these results establish cause for the consideration of the effects of neighborhood environments in developing intelligent intervention strategies for both pandemic recovery and preparation for future public health emergencies, especially among vulnerable populations.